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2025 ICD-10-CM code F53.1

Puerperal psychosis, also known as postpartum psychosis, is a rare but severe mental illness occurring shortly after childbirth, characterized by hallucinations, delusions, and mood swings.

Adhere to the official ICD-10-CM coding guidelines published by the Centers for Medicare & Medicaid Services (CMS).

Not applicable to ICD-10-CM codes.

Medical necessity for treatment of postpartum psychosis is established by the presence of severe symptoms that compromise the safety of the mother and/or infant. This necessitates urgent intervention to stabilize the patient's mental state and prevent potential harm.Documentation must clearly demonstrate the severity of the symptoms and their impact on the mother’s functioning and ability to care for the infant.

The clinical responsibility for managing postpartum psychosis involves a multidisciplinary approach.This may include psychiatrists, obstetricians, nurses, social workers, and psychologists.The psychiatrist typically leads in diagnosing and treating the psychotic symptoms, while other professionals address the patient’s physical and psychosocial needs, providing support for the mother and family.

IMPORTANT:No specific alternate codes.However, depending on the presenting symptoms and course of the illness, other ICD-10-CM codes might be considered in conjunction with F53.1, such as codes for mood disorders with psychotic features or other specified psychotic disorders, but only as a secondary diagnosis.

In simple words: Postpartum psychosis is a serious mental illness that can happen to mothers soon after having a baby. It can make a mother see or hear things that aren't there, have strange beliefs, and feel very up or down. It's important to get help right away because it can be dangerous for both the mother and the baby. Treatment usually involves medicine, therapy, and sometimes a stay in the hospital.

Puerperal psychosis (PP), or postpartum psychosis, is a severe psychiatric disorder typically manifesting within days of childbirth in a small percentage of women (approximately 1-2 per 1000).Key symptoms include hallucinations (auditory, visual, olfactory, or tactile), delusions (often related to the infant), disorganized thinking and speech, and significant mood swings, ranging from mania to depression.The onset is often abrupt, and the condition can rapidly worsen, posing risks to both mother and infant.Risk factors include a personal or family history of bipolar disorder or other psychotic disorders.Treatment typically involves hospitalization, antipsychotic medication, and possibly electroconvulsive therapy (ECT).Psychological therapies such as cognitive behavioral therapy (CBT) may also be beneficial during recovery.

Example 1: A 28-year-old primiparous woman develops auditory hallucinations and delusions about her newborn 72 hours postpartum. She is hospitalized for treatment with antipsychotics and supportive therapy., A 35-year-old multiparous woman with a history of bipolar disorder experiences a rapid onset of manic symptoms, including racing thoughts, impulsivity, and insomnia, along with delusions, two days after delivery. She is admitted to a psychiatric unit and starts on medication., A 30-year-old woman presents with postpartum depression symptoms that escalate to include hallucinations and disorganized thinking within the first week after giving birth.Her healthcare team initiates treatment with antipsychotics, and she participates in family therapy to manage the challenges of caring for her newborn.

Detailed documentation is crucial for accurate coding.This includes a comprehensive history of the patient's mental health, including any prior episodes of psychosis or mood disorders, a complete description of the presenting symptoms, including their severity, onset, and duration, the results of any laboratory tests (thyroid function, complete blood count), and the treatment plan, including medications, therapies, and disposition.

** Postpartum psychosis is a medical emergency requiring immediate intervention.Accurate documentation is crucial for appropriate reimbursement and effective patient care.Always consult the latest coding guidelines and payer-specific rules for proper billing and coding.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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